A few months ago I had the great pleasure to meet Marcus Hammarberg in person, when he came to my company’s office for a talk called ”The Bungsu Story”. This is an inspirational presentation how agile and lean principles saved a hospital in Indonesia. The speech was based on his experiences that are also covered in the book, that I’m now about to review: Salvation: The Bungsu Story

Salvation: The Bungsu Story - Cover

The book has six parts, 21 chapters and 326 pages. The subtitle is: ”How Lean and Kanban saved a small hospital in Indonesia. Twice. And can help you reshape work in your company.”

Content

”This book is not based on a true story – it is a true story.”

We enter the story right after a major disaster happens to the hospital. During the rain period the partly renovated roof has fallen in. By all means everything is at risk from this moment on. Marcus and his small team from the Salvation Army steps up to the challenge to help the management team of the hospital. But first he digs in, literally, cleaning up after the disaster with the roof. Theory of Constraints is used to improve the process, when the buckets are given up for rice bags (to get rid of the debris).

Part II is called ”The rebuild”. Now the work starts to save the hospital using agile and lean. Example of things that are introduced:

  • The Not List (to keep focus during discussion)
  • Limit WIP (minimize the number of concurrent work in the process to enable flow)
  • Three stages of coaching.
  • Definition of Done -> Gives common understanding.

Things start to move in the right direction, but not as swift as anticipated, but a motivation speech (fully covered in chapter 5) takes care of that!

”Measure to learn – not punish!”

In part III, named ”The backsliding”  the momentum from the start ends up in the inevitable plateau or decline. The war cry from mob programming: ”Turn up the good”  is one of the tools used to push forward. At one point Marcus jokingly says: ”If only there was another emergency for us to handle. That would be great for morale!” You should be careful with what you wish…

Circumstances running a hospital in Indonesia forces the management team to lower the income at the same time as increasing the cost, it is time to get down to business again for Marcus and his team.

”What is the smallest step you can take to see if you’re moving in the right direction?”

Visualizations are used throughout the whole story in Bungsu. Marcus advice is not to overdo the board, keep it simple to let the visualization evolve over time! Chapter 18 is called ”Trust, Transparency, Accountability”. Here the lovely story of Ibu Elsye is told (she is the General Manager of the hospital, taking care of everything else but health care and finance at the hospital). She is totally stressed out over her situation, but with some encouragement and guidance she makes wonders…

Recommendation

I can totally recommend this book! Here are my main reasons why:

  • This book is authentic (see the first quote above), it shows that lean and agile principles works even in a hospital (a context outside of IT)!
  • This book is the perfect sequel to ”Kanban in Action” (which Marcus co-wrote together with Joakim Sundén), which is more theoretical.
  • The chapter with the story of Ibu Elsye (that alone is worth the money buying this book)!

I had the huge honor to help Marcus out as a beta reader for this book, and it was really rewarding to revisit the text when 100% completed!

All the best,
 Tomas from TheAgileist

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